Endoscope assembly

ABSTRACT

A locomotive endoscope assembly including a locomotive endoscope head, including a main portion extending along a longitudinal axis and having a first selectably inflatable balloon associated therewith and a selectably positionable portion, selectably axially positionable along the main portion and having a second selectably inflatable balloon associated therewith and a locomotive endoscope head controller controlling the operation of the locomotive endoscope head and being operative for controlling positioning of the selectably positionable portion relative to the main portion and selectable inflation of the first and second selectably inflatable balloons.

REFERENCE TO RELATED APPLICATIONS

Reference is made to U.S. Provisional Patent Application 60/542,680,filed Feb. 9, 2004 entitled “MICRO-ROBOT AND ACCESSORIES FOR ENDOSCOPYAND IN-PIPE LOCOMOTION” and to U.S. Provisional Patent Application60/559,461, filed Apr. 6, 2004 entitled “DEVICES, ACCESSORIES ANDMETHODS FOR ENDOSCOPY AND IN-PIPE PROPAGATION”, the disclosures of whichare hereby incorporated by reference and priority of which is herebyclaimed pursuant to 37 CFR 1.78(a) (4) and (5)(i).

FIELD OF THE INVENTION

The present invention relates to endoscopy generally and moreparticularly to locomotive endoscopes.

BACKGROUND OF THE INVENTION

The following U.S. Patent Documents are believed to represent thecurrent state of the art:

U.S. Pat. Nos. 4,040,413; 4,176,662 and 5,662,587 and

U.S. Patent Application Publication No. 2002/0156347

SUMMARY OF THE INVENTION

The present invention seeks to provide an improved locomotive endoscope.

The terms “endoscope” and “endoscopy” are used herein in a mannersomewhat broader than their customary meaning and refer to apparatus andmethods which operate within body cavities, passageways and the like,such as, for example, the small intestine, the large intestine, arteriesand veins. Although these terms normally refer to visual inspection, asused herein they are not limited to applications which employ visualinspection and refer as well to apparatus, systems and methods whichneed not necessarily involve visual inspection.

There is thus provided in accordance with a preferred embodiment of thepresent invention a locomotive endoscope assembly including a locomotiveendoscope head, including a main portion extending along a longitudinalaxis and having a first selectably inflatable balloon associatedtherewith and a selectably positionable portion, selectably axiallypositionable along the main portion and having a second selectablyinflatable balloon associated therewith and a locomotive endoscope headcontroller controlling the operation of the locomotive endoscope headand being operative for controlling positioning of the selectablypositionable portion relative to the main portion and selectableinflation of the first and second selectably inflatable balloons.

In accordance with a preferred embodiment of the present invention atleast one of the first and second selectably inflatable balloonsincludes a stretchable balloon. Preferably, the locomotive endoscopeassembly also includes an endoscope body associated with the locomotiveendoscope head. Optionally and preferably, an instrument channel atleast partially extends through the locomotive endoscope head and theendoscope body.

In accordance with another preferred embodiment of the present inventionthe locomotive endoscope head has a fixed length. Preferably, theendoscope body includes a multi-lumen tube. Alternatively oradditionally, the endoscope body interfaces with the locomotiveendoscope head controller.

In accordance with yet another preferred embodiment of the presentinvention the locomotive endoscope assembly also includes an endoscopysystem to which the locomotive endoscope head controller is connectable.

In accordance with still another preferred embodiment of the presentinvention the multi-lumen tube includes at least one lumen operative forat least one of balloon inflation; positioning of the selectablypositionable portion of the locomotive endoscope head; passagetherethrough of at least one of an optical fiber and an electricalconductor bundle and fluid communication. Preferably, the multi-lumentube includes at least one lumen operative for each of ballooninflation; positioning of the selectably positionable portion of thelocomotive endoscope head and passage therethrough of at least one of anoptical fiber and an electrical conductor bundle. Typically andpreferably, the at least one lumen includes at least one first lumenoperative for inflation of the first selectably inflatable balloon andat least one second lumen operative for inflation of the secondselectably inflatable balloon.

In accordance with a further preferred embodiment of the presentinvention the selectably positionable portion is slidably positionablewith respect to the main portion. Preferably, the locomotive endoscopehead includes at least one light source and at least one imaging sensor.Additionally or alternatively, the first selectably inflatable balloonincludes at least two independently inflatable balloon portions. As afurther alternative, the second selectably inflatable balloon includesat least two independently inflatable balloon portions. Preferably, theat least two independently inflatable balloon portions of the secondselectably inflatable balloon are azimuthally offset with respect to theat least two independently inflatable balloon portions of the firstselectably inflatable balloon.

In accordance with a still further preferred embodiment of the presentinvention the locomotive endoscope head controller provides locomotivefunctionality adapted to sequentially displace the locomotive endoscopehead through a generally tabular body portion. Preferably, thelocomotive functionality includes functionality providing the followingsequential operations: inflating the first selectably inflatableballoon, thereby anchoring the first selectably inflatable balloon to aninterior surface of the generally tubular body portion; axiallyrepositioning the selectably positionable portion and the secondselectably inflatable balloon relative to the first selectablyinflatable balloon; inflating the second selectably inflatable balloon,thereby anchoring the second selectably inflatable balloon to aninterior surface of the generally tubular body portion; deflating thefirst selectably inflatable balloon, thereby unanchoring the firstselectably inflatable balloon from the interior surface of the generallytubular body portion; and axially repositioning the first selectablyinflatable balloon relative to the selectably positionable portion andthe second selectably inflatable balloon. Optionally, the firstselectably inflatable balloon is arranged with respect to the generallytubular body portion to be forward of the second selectably inflatableballoon. Alternatively, the second selectably inflatable balloon isarranged with respect to the generally tubular body portion to beforward of the first selectably inflatable balloon.

There is also provided in accordance with another preferred embodimentof the present invention a locomotive endoscope assembly including alocomotive endoscope head, including a main portion extending along alongitudinal axis and having a first selectably radially extendibleelement associated therewith and a selectably positionable portion,selectably axially positionable along the main portion and having asecond selectably radially extendible element associated therewith and alocomotive endoscope head controller controlling the operation of thelocomotive endoscope head and being operative for controllingpositioning of the selectably positionable portion relative to the mainportion and selectable extension of the first and second selectablyradially extendible elements.

In accordance with a preferred embodiment of the present invention atleast one of the first and second selectably radially extendibleelements includes a selectably inflatable balloon. Preferably, theselectably inflatable balloon includes a stretchable balloon.

In accordance with another preferred embodiment of the present inventionthe locomotive endoscope assembly also includes an endoscope bodyassociated with the locomotive endoscope head. Preferably, an instrumentchannel at least partially extends through the locomotive endoscope headand the endoscope body. More preferably the locomotive endoscope headhas a fixed length.

In accordance with yet another preferred embodiment of the presentinvention the endoscope body includes a multi-lumen tube. Preferably,the endoscope body interfaces with the locomotive endoscope headcontroller. Additionally and preferably, the locomotive endoscopeassembly also includes an endoscopy system to which the locomotiveendoscope head controller is connectable.

In accordance with still another preferred embodiment of the presentinvention the multilumen tube includes at least one lumen operative forat least one of radially extending element extension; positioning of theselectably positionable portion of the locomotive endoscope head;passage therethrough of at least one of an optical fiber and anelectrical conductor bundle; and fluid communication. Preferably, themulti-lumen tube includes at least one lumen operative for each ofradially extending element extension; positioning of the selectablypositionable portion of the locomotive endoscope head; and passagetherethrough of at least one of an optical fiber and an electricalconductor bundle. Typically and preferably, the at least one lumenincludes at least one first lumen operative for extension of the firstselectably radially extendible element and at least one second lumenoperative for extension of the second selectably radially extendibleelement.

In accordance with yet a further preferred embodiment of the presentinvention the selectably positionable portion is slidably positionablewith respect to the main portion. Preferably, the locomotive endoscopehead includes at least one light source and at least one imaging sensor.

In accordance with yet a further preferred embodiment of the presentinvention the first selectably radially extendible element includes atleast two independently extendible element portions. Additionally oralternatively, the second selectably radially extendible elementincludes at least two independently extendible element portions.Preferably, the at least two independently extendible element portionsof the second selectably radially extendible element are azimuthallyoffset with respect to the at least two independently extendible elementportions of the first selectably radially extendible element.

In accordance with still a further preferred embodiment of the presentinvention the locomotive endoscope head controller provides locomotivefunctionality adapted to sequentially displace the locomotive endoscopehead through a generally tubular body portion. Preferably, thelocomotive functionality includes functionality providing the followingsequential operations: extending the first selectably radiallyextendible element, thereby anchoring the first selectably radiallyextendible element to an interior surface of the generally tubular bodyportion; axially repositioning the selectably positionable portion andthe second selectably radially extendible element relative to the firstselectably radially extendible element; extending the second selectablyradially extendible element, thereby anchoring the second selectablyradially extendible element to an interior surface of the generallytubular body portion; retracting the first selectably radiallyextendible element, thereby unanchoring the first selectably radiallyextendible element from the interior surface of the generally tubularbody portion; and axially repositioning the first selectably radiallyextendible element relative to the selectably positionable portion andthe second selectably radially extendible element. Optionally, the firstselectably radially extendible element is arranged with respect to thegenerally tubular body portion to be forward of the second selectablyradially extendible element. Alternatively, the second selectablyradially extendible element is arranged with respect to the generallytubular body portion to be forward of the first selectably radiallyextendible element.

There is further provided in accordance with yet another preferredembodiment of the present invention an endoscope assembly including anendoscope head extending along a longitudinal axis and having a firstplurality of selectably inflatable balloons associated therewith atleast one first axial location therealong and a second plurality ofselectably inflatable balloons associated therewith at least one secondaxial location therealong and an endoscope head controller beingoperative for controlling selectable inflation of the first and secondpluralities of selectably inflatable balloons for selectable positioningof the endoscope head.

In accordance with a preferred embodiment of the present invention theendoscope head controller is operative for controlling selectableinflation of the first and second pluralities of selectably inflatableballoons for selectable parallel off-center orientation of the endoscopehead. Preferably, the endoscope head controller is operative forcontrolling selectable inflation of the first and second pluralities ofselectably inflatable balloons for selectable tilted orientation of theendoscope head. Optionally and preferably, at least one of the first andsecond pluralities of selectably inflatable balloons includes aplurality of balloons distributed generally azimuthally about theendoscope head. More preferably, at least one balloon of the first andsecond pluralities of selectably inflatable balloons includes astretchable balloon.

In accordance with another preferred embodiment of the present inventionthe endoscope head includes a locomotive endoscope head. Preferably, thelocomotive endoscope head includes a main portion extending along alongitudinal axis and associated with the first plurality of selectablyinflatable balloons, and a selectably positionable portion, selectablyaxially positionable along the main portion and associated with thesecond plurality of selectably inflatable balloons.

In accordance with still another preferred embodiment of the presentinvention the endoscope assembly also includes an endoscope bodyassociated with the endoscope head. Preferably, an instrument channel atleast partially extends through the endoscope head and the endoscopebody. Optionally and preferably, the endoscope head has a fixed length.

In accordance with a further preferred embodiment of the presentinvention the endoscope body includes a multi-lumen tube. Additionallyor alternatively the endoscope body interfaces with the endoscope headcontroller. Preferably, the endoscope assembly also includes anendoscopy system to which the endoscope head controller is connectable.

In accordance with yet a further preferred embodiment of the presentinvention the multi-lumen tube includes at least one lumen operative forat least one of balloon inflation; positioning of the selectablypositionable portion of the endoscope head; passage therethrough of atleast one of an optical fiber and an electrical conductor bundle; andfluid communication. Preferably, the multi-lumen tube includes at leastone lumen operative for each of balloon inflation; positioning of theselectably positionable portion of the endoscope head; and passagetherethrough of at least one of an optical fiber and an electricalconductor bundle.

In accordance with a still further preferred embodiment of the presentinvention the selectably positionable portion is slidably positionablewith respect to the main portion. Preferably, the endoscope headincludes at least one light source and at least one imaging sensor.Additionally or alternatively, the first plurality of selectablyinflatable balloons includes at least two independently inflatableballoon portions. As a further alternative, the second plurality ofselectably inflatable balloons includes at least two independentlyinflatable balloon portions. Preferably, the at least two independentlyinflatable balloon portions of the second plurality of selectablyinflatable balloons are azimuthally offset with respect to the at leasttwo independently inflatable balloon portions of the first plurality ofselectably inflatable balloons.

In accordance with an additional preferred embodiment of the presentinvention the endoscope head controller provides locomotivefunctionality adapted to sequentially displace the endoscope headthrough a generally tubular body portion. Preferably, the locomotivefunctionality includes functionality providing the following sequentialoperations: inflating at least part of the first plurality of selectablyinflatable balloons, thereby anchoring the first plurality of selectablyinflatable balloons to an interior surface of the generally tubular bodyportion; axially repositioning the selectably positionable portion andthe second plurality of selectably inflatable balloons relative to thefirst plurality of selectably inflatable balloons; inflating at leastpart of the second plurality of selectably inflatable balloons, therebyanchoring the second plurality of selectably inflatable balloons to aninterior surface of the generally tubular body portion; deflating thefirst plurality of selectably inflatable balloons, thereby unanchoringthe first plurality of selectably inflatable balloons from the interiorsurface of the generally tubular body portion; and axially repositioningthe first plurality of selectably inflatable balloons relative to theselectably positionable portion and the second plurality of selectablyinflatable balloons. Optionally, the first plurality of selectablyinflatable balloons is arranged with respect to the generally tubularbody portion to be generally forward of the second plurality ofselectably inflatable balloons. Alternatively, the second plurality ofselectably inflatable balloons is arranged with respect to the generallytubular body portion to be generally forward of the first plurality ofselectably inflatable balloons.

There is additionally provided in accordance with still anotherpreferred embodiment of the present invention an endoscope assemblyincluding an endoscope head extending along a longitudinal axis andhaving a first plurality of selectably radially extendible elementsassociated therewith at least one first axial location therealong and asecond plurality of selectably radially extendible elements associatedtherewith at least one second axial location therealong and an endoscopehead controller being operative for controlling selectable extension ofthe first and second pluralities of selectably radially extendibleelements for selectable positioning of the endoscope head.

In accordance with a preferred embodiment of the present invention theendoscope head controller is operative for controlling selectableextension of the first and second pluralities of selectably radiallyextendible elements for selectable parallel off-center orientation ofthe endoscope head. Preferably, the endoscope head controller isoperative for controlling selectable extension of the first and secondpluralities of selectably radially extendible elements for selectabletilted orientation of the endoscope head. Additionally or alternatively,at least one of the first and second pluralities of selectably radiallyextendible elements includes a plurality of radially extendible elementsdistributed generally azimuthally about the endoscope head.

In accordance with another preferred embodiment of the present inventionthe endoscope head includes a locomotive endoscope head. Preferably, thelocomotive endoscope head includes a main portion extending along alongitudinal axis and associated with the first plurality of selectablyradially extendible elements, and a selectably positionable portion,selectably axially positionable along the main portion and associatedwith the second plurality of selectably radially extendible elements.

In accordance with yet another preferred embodiment of the presentinvention least one of the first and second pluralities of selectablyradially extendible elements includes a plurality of selectablyinflatable balloons. Typically and preferably, at least one balloon ofthe plurality of selectably inflatable balloons includes a stretchableballoon.

In accordance with still another preferred embodiment of the presentinvention the endoscope assembly also includes an endoscope bodyassociated with the endoscope head. Preferably, an instrument channel atleast partially extends through the endoscope head and the endoscopebody. Additionally or alternatively, the endoscope head has a fixedlength.

In accordance with a further preferred embodiment of the presentinvention the endoscope body includes a multi-lumen tube. Preferably,the endoscope body interfaces with the endoscope head controller.Additionally or alternatively, the endoscope assembly also includes anendoscopy system to which the endoscope head controller is connectable.

In accordance with a still further preferred embodiment of the presentinvention the multi-lumen tube includes at least one lumen operative forat least one of: radially extending element extension; positioning ofthe selectably positionable portion of the endoscope head; passagetherethrough of at least one of an optical fiber and an electricalconductor bundle; and fluid communication. Preferably, the multi-lumentube includes at least one lumen operative for each of: radiallyextending element extension; positioning of the selectably positionableportion of the endoscope head; and passage therethrough of at least oneof an optical fiber and an electrical conductor bundle.

In accordance with an additional preferred embodiment of the presentinvention the selectably positionable portion is slidably positionablewith respect to the main portion. Preferably, the endoscope headincludes at least one light source and at least one imaging sensor.Additionally or alternatively, the first plurality of selectablyradially extendible elements includes at least two independentlyselectably radially extendible elements. As a further alternative, thesecond plurality of selectably radially extendible elements includes atleast two independently selectably radially extendible elements.Preferably, the at least two independently selectably radiallyextendible elements of the second plurality of selectably radiallyextendible elements are azimuthally offset with respect to the at leasttwo independently selectably radially extendible elements of the firstplurality of selectably radially extendible elements.

In accordance with another preferred embodiment of the present inventionthe endoscope head controller provides locomotive functionality adaptedto sequentially displace the endoscope head through a generally tubularbody portion. Preferably, the locomotive functionality includesfunctionality providing the following sequential operations: extendingat least part of the first plurality of selectably radially extendibleelements, thereby anchoring the first plurality of selectably radiallyextendible elements to an interior surface of the generally tubular bodyportion; axially repositioning the selectably positionable portion andthe second plurality of selectably radially extendible elements relativeto the first plurality of selectably radially extendible elements;extending at least part of the second plurality of selectably radiallyextendible elements, thereby anchoring the second plurality ofselectably radially extendible elements to an interior surface of thegenerally tubular body portion; retracting the first plurality ofselectably radially extendible elements, thereby unanchoring the firstplurality of selectably radially extendible elements from the interiorsurface of the generally tubular body portion; and axially repositioningthe first plurality of selectably radially extendible elements relativeto the selectably positionable portion and the second plurality ofselectably radially extendible elements. Optionally, the first pluralityof selectably radially extendible elements is arranged with respect tothe generally tubular body portion to be generally forward of the secondplurality of selectably radially extendible elements. Alternatively, thesecond plurality of selectably radially extendible elements is arrangedwith respect to the generally tubular body portion to be generallyforward of the first plurality of selectably radially extendibleelements.

There is also provided in accordance with another preferred embodimentof the present invention apparatus for fluid supply to the interior of aportion of a tubular body portion including an element extending along alongitudinal axis and having at least one first selectably extendibletubular body portion sealing element associated therewith at a firstaxial location therealong and at least one second tubular body portionsealing element associated therewith at a second axial locationtherealong, a controller for selectably extending the at least one firstand second tubular body portion sealing elements within a tubular bodyportion to define a sealed region therebetween and a fluid supplyfunctionality supplying a fluid to the sealed region.

In accordance with a preferred embodiment of the present invention atleast one of the first and second tubular body portion sealing elementsincludes a selectably inflatable balloon. Preferably, the selectablyinflatable balloon includes a stretchable balloon. More preferably, theselectably inflatable balloon includes a plurality of selectablyinflatable balloon portions.

In accordance with another preferred embodiment of the present inventionthe apparatus includes a locomotive endoscope head. Preferably, theapparatus for fluid supply also includes at least one fluid supplyreservoir which is operative to supply the fluid to the sealed region.More preferably, the apparatus for fluid supply also includes fluidsuction functionality for suctioning fluid from the sealed region.

There is further provided in accordance with a further preferredembodiment of the present invention apparatus for fluid supply to theinterior of a portion of a tubular body portion including a multi-lumentube including at least first, second and third lumens extendingtherethrough, a forward selectably inflatable balloon in fluidcommunication with the first lumen, the forward selectably inflatableballoon being operative to seal the tubular body portion when inflated,a rear selectably inflatable balloon in fluid communication with thesecond lumen, the rear selectably inflatable balloon being operative toseal the tubular body portion when inflated, a fluid supply outlet,located intermediate the forward and rear selectably inflatableballoons, the outlet being in fluid communication with the third lumenand a controller for selectably inflating the first and secondselectably inflatable balloons within a tubular body portion to define asealed region therebetween and for supplying a fluid to the sealedregion.

There is additionally provided in accordance with still anotherpreferred embodiment of the present invention an endoscope assemblyincluding an endoscope tube having an instrument channel an endoscopetool arranged to travel along the instrument channel to a utilizationlocation forward of the endoscope tube, the endoscope tool beingslidably and sealingly located within the instrument channel and a fluidendoscope tool positioner for selectably pressurizing the instrumentchannel for providing fluid driven desired positioning of the endoscopetool along the instrument channel.

In accordance with a preferred embodiment of the present invention theendoscope tool includes a piston-defining portion sealingly and slidablyengaging the instrument channel.

There is provided in accordance with a preferred embodiment of thepresent invention an endoscope assembly including a tube having at leastone lumen and an endoscope tool arranged to travel through the at leastone lumen, the endoscope tool including a stretchable selectablyinflatable anchoring balloon.

There is also provided in accordance with another preferred embodimentof the present invention an endoscope assembly including a tube havingat least one lumen and an endoscope tool arranged to travel along the atleast one lumen to a utilization location forward of the tube, theendoscope tool being selectably bendable forwardly of the tube.

There is additionally provided in accordance with yet another preferredembodiment of the present invention an endoscope assembly including atube having at least one lumen and an endoscope tool arranged to travelalong the at least one lumen, the endoscope tool including a tool headand a multi-lumen tube connected to the tool head.

In accordance with a preferred embodiment of the present invention thetube includes an endoscope tube. Preferably, the at least one lumenincludes instrument channel. Additionally or alternatively, themulti-lumen tube includes at least a first lumen for inflation anddeflation of the stretchable selectably inflatable anchoring balloon anda second lumen.

In accordance with another preferred embodiment of the present inventionthe endoscope assembly also includes a tensioning wire which extendsthrough the second lumen and which is operative for selectably bendingthe endoscope tool forwardly of the tube. Preferably, the endoscope toolis generally more flexible than the tube. Additionally or alternatively,the endoscope assembly also includes an endoscopy system to which theendoscope tube is connectable. As a further alternative, the endoscopeassembly also includes an endoscope tool positioning control device anda balloon inflation/deflation control.

In accordance with yet another preferred embodiment of the presentinvention the endoscope assembly also includes a tool port associatedwith the tube which is operative for insertion and removal of theendoscope tool.

There is further provided in accordance with a further preferredembodiment of the present invention an endoscope assembly including anendoscope tube, the endoscope tube having a first stretchable selectablyinflatable anchoring balloon adjacent a forward end thereof and anendoscope tool arranged to travel relative to the endoscope tube to autilization location forward of the endoscope tube, the endoscope toolhaving a second stretchable selectably inflatable anchoring balloonadjacent a forward end thereof.

In accordance with a preferred embodiment of the present invention theendoscope tool is selectably bendable forwardly of the endoscope tube.Optionally and preferably, the endoscope tool includes a tool head and amulti-lumen tube connected to the tool head. Additionally oralternatively, the multi-lumen tube includes at least a first lumen forinflation and deflation of the second stretchable selectably inflatableanchoring balloon and a second lumen.

In accordance with another preferred embodiment of the present inventionthe endoscope assembly also includes a tensioning wire which extendsthrough the second lumen and which is operative for selectably bendingthe endoscope tool forwardly of the endoscope tube. Preferably, theendoscope tool is generally more flexible than the endoscope tube.Additionally or alternatively, the endoscope assembly also includes anendoscopy system to which the endoscope tube is connectable.Additionally or alternatively, the endoscope assembly also includes anendoscope tool positioning control device and at least one ballooninflation/deflation control. As a further alternative, the endoscopeassembly also includes a tool port associated with the endoscope tubewhich is operative for insertion and removal of the endoscope tool.

There is yet further provided in accordance with yet another preferredembodiment of the present invention an endoscope assembly including alocomotive endoscope including a locomotive endoscope head and anendoscope body adapted for locomotion through a tubular body portion andfor anchoring at a desired location in the tubular body portion and anendoscopy tool adapted for displacement along the endoscope body to adesired tool operation location.

In accordance with a preferred embodiment of the present invention theendoscope assembly also includes at least one selectably radiallyextendible element associated with the locomotive endoscope head andadapted for anchoring the locomotive endoscope head at a desiredlocation in the tubular body portion. Preferably, the at least oneselectably radially extendible element includes a selectably inflatableanchoring balloon. Additionally or alternatively, the locomotiveendoscope head includes at least one light source and at least oneimaging sensor.

In accordance with another preferred embodiment of the present inventionthe endoscope assembly also includes an overtube which is slidable alongthe endoscope body. Preferably, the overtube is associated with theendoscopy tool. Additionally or alternatively, the endoscope body isadapted to function as a guide wire for the overtube.

In accordance with yet another preferred embodiment of the presentinvention the endoscopy tool includes a therapeutic tool. Alternatively,the endoscopy tool includes a diagnostic tool. As a further alternative,the endoscopy tool includes a surgical tool.

There is also provided in accordance with another preferred embodimentof the present invention a locomotive endoscopy method includingproviding a locomotive endoscope head, including a main portionextending along a longitudinal axis and having a first selectablyradially extendible element associated therewith and a selectablypositionable portion, selectably axially positionable along the mainportion and having a second selectably radially extendible elementassociated therewith and providing locomotion of the locomotiveendoscope head by selectably positioning the slidable portion relativeto the main portion and selectably extending and retracting the firstand second selectably radially extendible elements.

In accordance with a preferred embodiment of the present invention atleast one of the first and second selectably radially extendibleelements includes a selectably inflatable balloon. Preferably, thelocomotive endoscopy method also includes positioning the locomotiveendoscope head in a selectably non-parallel orientation relative to atubular body portion by selectably non-identically extending at leasttwo independently radially extendible element portions of the firstselectably radially extendible element and at least two independentlyradially extendible element portions of the second selectably radiallyextendible element. Additionally or alternatively, the locomotiveendoscopy method also includes positioning the locomotive endoscope headin a selectably off-center parallel orientation relative to a tubularbody portion by selectably non-identically extending at least twoindependently radially extendible element portions of the firstselectably radially extendible element and at least two independentlyradially extendible element portions of the second selectably radiallyextendible element.

In accordance with another preferred embodiment of the present inventionproviding locomotion includes sequentially displacing the locomotiveendoscope head through a generally tubular body portion. Preferably,providing locomotion includes sequentially displacing the locomotiveendoscope head through at least one of a large intestine, a smallintestine, an artery and a vein. More preferably, the sequentiallydisplacing includes the following sequential operations: extending thefirst selectably radially extendible element, thereby anchoring thefirst selectably radially extendible element to an interior surface ofthe generally tubular body portion; axially repositioning the selectablypositionable portion and the second selectably radially extendibleelement relative to the first selectably radially extendible element;inflating the second selectably radially extendible element, therebyanchoring the second selectably radially extendible element to aninterior surface of the generally tubular body portion; deflating thefirst selectably radially extendible element, thereby unanchoring thefirst selectably radially extendible element from the interior surfaceof the generally tubular body portion; and axially repositioning thefirst selectably radially extendible element relative to the selectablypositionable portion and the second selectably radially extendibleelement.

There is additionally provided in accordance with yet another preferredembodiment of the present invention an endoscope positioning methodincluding providing an endoscope head extending along a longitudinalaxis and having a first plurality of selectably radially extendibleelements associated therewith at least a first axial location therealongand a second plurality of selectably radially extendible elementsassociated therewith at least a second axial location therealong andselectably positioning the endoscope head by selectable extension of thefirst and second pluralities of selectably radially extendible elements.

In accordance with a preferred embodiment of the present invention atleast one of the first and second pluralities of selectably radiallyextendible elements includes a plurality of radially extendible elementsdistributed azimuthally about the endoscope head and the positioning theendoscope head includes selectable extension of individual ones of theplurality of radially extendible elements. Preferably, at least oneselectably radially extendable element of the first and secondpluralities of selectably radially extendible elements includes aninflatable balloon.

There is further provided in accordance with still another preferredembodiment of the present invention a method for fluid supply to theinterior of a portion of a tubular body portion including providing anelement extending along a longitudinal axis and having at least onefirst selectably extendible tubular body portion sealing elementassociated therewith at a first axial location therealong and at leastone second tubular body portion sealing element associated therewith ata second axial location therealong, extending the at least one first andsecond tubular body portion sealing elements within a tubular bodyportion to define a sealed region therebetween and supplying a fluid tothe sealed region.

In accordance with a preferred embodiment of the present invention thesupplying a fluid includes supplying a therapeutic fluid. Alternatively,the supplying a fluid includes supplying a contrast enhancing fluid. Asa further alternative, the supplying a fluid includes supplying anantiseptic fluid.

In accordance with another preferred embodiment of the present inventionthe supplying a fluid includes supplying an acidic solution.Alternatively, the supplying a fluid includes supplying a basicsolution.

There is also provided in accordance with a further preferred embodimentof the present invention an endoscopy method including providing anendoscope tube having an instrument channel and an endoscope toolarranged to travel along the instrument channel to a utilizationlocation forward of the endoscope tube, the endoscope tool beingslidably and sealingly located within the instrument channel andselectably pressurizing the instrument channel for providing fluiddriven desired positioning of the endoscope tool along the instrumentchannel.

There is additionally provided in accordance with a still furtherpreferred embodiment of the present invention an endoscopy methodincluding providing a tube having at least one lumen and an endoscopetool arranged to travel through the at least one lumen, the endoscopetool including a stretchable selectably inflatable anchoring balloon andanchoring the endoscope tool forward of the tube within a tubular bodyportion by inflating the anchoring balloon into anchoring engagementwith an interior wall of the tubular body portion.

There is also provided in accordance with another preferred embodimentof the present invention an endoscopy method including providing a tubehaving at least one lumen and an endoscope tool arranged to travelthrough the at least one lumen, the endoscope tool being selectablybendable forwardly of the tube and selectably bending the endoscope toolforwardly of the tube.

In accordance with a preferred embodiment of the present invention theendoscope tool includes a stretchable selectably inflatable anchoringballoon and the method also includes anchoring the endoscope toolforward of the tube within a tubular body portion by inflating theanchoring balloon into anchoring engagement with an interior wall of thetubular body portion. Preferably, the endoscopy method also includessliding the tube forwardly along the endoscope tool, thereby employingthe endoscope tool as a guide.

In accordance with another preferred embodiment of the present inventionthe endoscopy method also includes, prior to sliding the tube forwardly,the step of tensioning the endoscope tool. Preferably, the endoscopymethod also includes the steps of sequentially repeating at least two ofthe anchoring, tensioning and sliding steps.

In accordance with yet another preferred embodiment of the presentinvention the tube includes an endoscope tube. Preferably, the at leastone lumen includes an instrument channel.

There is also provided in accordance with a still further preferredembodiment of the present invention an endoscopy method includingproviding an endoscope tube having a first stretchable selectablyinflatable anchoring balloon adjacent a forward end thereof and anendoscope tool having a second stretchable selectably inflatableanchoring balloon adjacent a forward end thereof and positioning theendoscope tool at a utilization location forward of the endoscope tube.

In accordance with a preferred embodiment of the present invention theendoscopy method also includes prior to the positioning, inflating thefirst selectably inflatable anchoring balloon on the endoscope tubewithin a tubular body portion for anchoring the endoscope tube to aninner wall of the tubular body portion, subsequent to the positioning,inflating the second selectably inflatable anchoring balloon on the toolforward of the endoscope tube within the tubular body portion foranchoring the endoscope tool to the inner wall of the tubular bodyportion, thereafter, deflating the first selectably inflatable anchoringballoon and advancing the endoscope tube over the endoscope tool byemploying the endoscope tool as a guide.

In accordance with another preferred embodiment of the present inventionthe endoscopy method also includes bending the endoscope tool when it isforward of the endoscope tube and prior to inflating the secondselectably inflatable anchoring balloon. Preferably, the endoscopymethod also includes the step of sequentially repeating at least two ofthe inflating, positioning, deflating and advancing steps.

In accordance with yet another preferred embodiment of the presentinvention the endoscopy method also includes the step of sequentiallyrepeating at least two of the inflating, positioning, bending, deflatingand advancing steps. Preferably, the positioning of the endoscope toolincludes passing the endoscope tool through an instrument channel of theendoscope tube.

There is further provided in accordance with another preferredembodiment of the present invention an endoscopy method includingproviding a locomotive endoscope including a locomotive endoscope headand an endoscope body, providing locomotion of the locomotive endoscopehead through a tubular body portion, anchoring the locomotive endoscopehead at a desired location in the tubular body portion and displacing anendoscopy tool along the endoscope body to a desired tool operationlocation.

In accordance with a preferred embodiment of the present invention theendoscopy method also includes tensioning the endoscope body followingthe anchoring of the locomotive endoscope head and prior to thedisplacing the endoscopy tool. Preferably, the endoscopy method alsoincludes, prior to the anchoring, the step of detecting the desiredlocation in the tubular body portion by use of at least one light sourceand at least one imaging sensor associated with the locomotive endoscopehead.

In accordance with another preferred embodiment of the present inventionthe endoscopy method also includes, prior to the displacing theendoscopy tool, the step of detecting the desired tool operationlocation in the tubular body portion by use of at least one light sourceand at least one imaging sensor associated with the locomotive endoscopehead. Preferably, the displacing the endoscopy tool includes sliding anovertube associated with the endoscopy tool over the endoscope body.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will be understood and appreciated more fully fromthe following detailed description, taken in conjunction with thedrawings in which:

FIG. 1 is a simplified pictorial illustration of an endoscopy systemconstructed and operative in accordance with a preferred embodiment ofthe present invention;

FIGS. 2 and 3 are respective simplified exploded and assembled viewillustrations of a locomotive endoscope head constructed and operativein accordance with a preferred embodiment of the present invention;

FIGS. 4A, 4B and 4C are simplified sectional illustrations taken alongrespective lines IVA-IVA, IVB-IVB and IVC-IVC in FIG. 3;

FIGS. 5A, 5B, 5C, 5D, 5E, 5F and 5G are simplified sectionalillustrations, taken along lines IVB-IVB in FIG. 3 of the locomotiveendoscope head of FIGS. 2-4C at various stages of forward motion throughan intestine;

FIGS. 6A, 6B, 6C, 6D, 6E, 6F and 6G are simplified sectionalillustrations, taken along lines IVB-IVB in FIG. 3 of the locomotiveendoscope head of FIGS. 2-4C at various stages of rearward motionthrough an intestine;

FIGS. 7A, 7B and 7C are side view illustrations of selectable tiltingorientation of the locomotive endoscope head of FIGS. 1-6G within a bodypassageway;

FIGS. 8A, 8B and 8C are simplified rearward facing views correspondingto FIGS. 7A, 7B and 7C, taken along planes VIIIA-VIIIA, VIIIB-VIIIB andVIIIC-VIIIC in FIGS. 7A, 7B and 7C respectively;

FIGS. 9A, 9B and 9C are simplified forward facing views corresponding toFIGS. 7A, 7B and 7C, taken along planes IXA-IXA, IXB-IXB and IXC-IXC inFIGS. 7A, 7B and 7C respectively;

FIGS. 10A and 10B are side view illustrations of selectable parallelorientation of the locomotive endoscope head of FIGS. 1-6G within a bodypassageway;

FIGS. 11A and 11B are simplified rearward facing views corresponding toFIGS. 10A and 10B taken along planes XIA-XIA and XIB-XIB in FIGS. 10Aand 10B respectively;

FIGS. 12A and 12B are simplified forward facing views corresponding toFIGS. 10A and 100B taken along planes XIIA-XIIA and XIIB-XIIB in FIGS.10A and 10B respectively;

FIG. 13 is a simplified pictorial illustration of an accessory which isadapted to travel through the instrument channel in the locomotiveendoscope head of any of FIGS. 1-12B;

FIG. 14 is a simplified partially block diagram, partially schematicillustration of part of the endoscopy system of FIGS. 1-13, constructedand operative in accordance with a preferred embodiment of the presentinvention;

FIG. 15 is a simplified pictorial illustration of the locomotiveendoscope head of FIGS. 1-12B in an intestine fluid treatment mode ofoperation;

FIGS. 16A, 16B and 16C, are simplified pictorial illustrations of thelocomotive endoscope head of FIGS. 1-12B in a guide wire mode ofoperation.

FIG. 17 is a simplified pictorial illustration of an endoscopy systemconstructed and operative in accordance with another preferredembodiment of the present invention;

FIGS. 18, 19A and 19B are respective simplified pictorial and sectionalview illustrations of an accessory constructed and operative inaccordance with a preferred embodiment of the present invention;

FIGS. 20A, 20B, 20C, 20D, 20E, 20F, 20G, 20H and 20I are simplifiedillustrations of various functionalities which may be provided by thesystem of FIG. 17.

FIG. 21 is a simplified pictorial illustration of an endoscopy systemconstructed and operative in accordance with another preferredembodiment of the present invention;

FIGS. 22, 23A and 23B are respective simplified pictorial and sectionalview illustrations of an accessory constructed and operative inaccordance with a preferred embodiment of the present invention; and

FIGS. 24A, 24B, 24C, 24D, 24E, 24F, 24G, 24H, 24I, 24J, 24K and 24L aresimplified illustrations of various functionalities which may beprovided by the system of FIG. 21.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Reference is now made to FIG. 1, which is a simplified pictorialillustration of an endoscopy system constructed and operative inaccordance with a preferred embodiment of the present invention.

The terms “endoscope” and “endoscopy” are used throughout in a mannersomewhat broader than their customary meaning and refer to apparatus andmethods which operate within body cavities, passageways and the like,such as, for example, the small intestine, the large intestine, arteriesand veins. Although these terms normally refer to visual inspection, asused herein they are not limited to applications which employ visualinspection and refer as well to apparatus, systems and methods whichneed not necessarily involve visual inspection.

As seen in FIG. 1, a conventional endoscopy system 100, such as aconsole including a CV-160 video system center, a CLC-160 light source,an OEV-203 video monitor, and an OFP flushing pump, all commerciallyavailable from Olympus America Inc. of 2 Corporate Center Drive,Melville, N.Y. 11747, USA, is being employed. A locomotive endoscopehead 102, constructed and operative in accordance with a preferredembodiment of the present invention is located within the largeintestine of a patient and is coupled to system 100 by a multi-lumentube 104, also constructed and operative in accordance with a preferredembodiment of the present invention, which interfaces with locomotivehead controller 106 and an operator control 108, both of which are alsoconstructed and operative in accordance with a preferred embodiment ofthe present invention.

Reference is now made to FIGS. 2 and 3, which are respective simplifiedexploded and assembled view illustrations of a locomotive endoscope headconstructed and operative in accordance with a preferred embodiment ofthe present invention and to FIGS. 4A, 4B and 4C, which are simplifiedsectional illustrations taken along respective lines IVA-IVA, IVB-IVBand IVC-IVC in FIG. 3.

As seen in FIGS. 2-4C, a multi-lumen tube 104, having a centralpassageway 202, defining an instrument channel useful inter alia fortool insertion, inflation and suction, and a plurality of peripherallumens 204, typically ten in number, is seated in a suitably configuredrecess 206 formed in a housing portion 208. Housing portion 208, whichis generally symmetric about a longitudinal axis 210, includes arelatively wider rear portion 212, which defines recess 206 and arelatively narrower main portion 214.

Rear portion 212 is formed with three pairs 220 of axial slits whichextend to the rear of rear portion 212 and which are mutually separatedalong the circumference of rear portion 212 by 120 degrees. Intermediateeach pair 220 of axial slits, there is provided an inflation passageway222, each of which communicates with a corresponding inflationpassageway 224 formed in multi-lumen tube 202, which in turncommunicates with a respective one of three rear balloon inflationlumens 226, which are included in the nine multiple peripheral lumens204. Rear balloon inflation lumens 226 are sealed forwardly of inflationpassageways 224 by seals 228.

Main portion 214 is formed with three axial slots 230 which extend tothe rear of rear portion 212 and which are mutually separated along thecircumference of rear portion 212.

A slidable forward balloon support 238 is slidably mounted onto mainportion 214 of housing portion 208. Forward balloon support 238 isformed with three pairs 240 of axial slits which extend to the rear offorward balloon support 238 and which are mutually separated along thecircumference of forward balloon support 238 by 120 degrees.Intermediate each pair 240 of axial slits, there is provided aninflation passageway 242, each of which communicates with acorresponding inflation passageway 244 which extends rearwardly intoslidable sealing engagement with a respective one of three forwardballoon inflation lumens 246, which are included in the nine multipleperipheral lumens 204. It is appreciated that inflation passageways 244are typically relatively rigid and sealingly slide within suitablyconfigured low friction liners 248 which are inserted into forwardballoon inflation lumens 246 at the forward end of the multi-lumen tube104.

A pair of piston rods 250 are fixed to or integrally formed with forwardballoon support 238 and extend inwardly and rearwardly thereof intoslidable sealing engagement with a respective one of two forward balloonsupport axial positioning lumens 252, which are included in the tenmultiple peripheral lumens 204. It is appreciated that piston rods 250are typically relatively rigid and sealingly slide within suitablyconfigured low friction liners 254 which are inserted into forwardballoon support axial positioning lumens 252 at the forward end of themulti-lumen tube 104.

The relatively rigid inflation passageways 244 and the piston rods 250are preferably located within axial slots 230.

A front housing portion 260 is fixedly mounted onto a forward end 262 ofthe main portion 214 of the housing portion 208. Front housing portionincludes a cap portion 264 which is fixed to or integrally formed with acylindrical portion 266 which extends through a central bore 268 ofslidable forward balloon support 238. A rearward end of cylindricalportion 266 is seated in a recess 270 and against a shoulder 272 definedin central passageway 202 of multi-lumen tube 104. An interior bore 274of cylindrical portion 266 defines a continuation of the instrumentchannel defined by central passageway 202.

At a forward end of cap portion 264 there are preferably provided alight emitting diode 280 and one or more imaging sensors 282. Electricalcurrent is supplied to the light emitting diode 280 and imaging data isreceived from sensors 282 via an optical fiber and electrical conductorbundle 284 which extends from the forward end of cap portion 264,through a peripheral lumen 286 in multi-lumen tube 104 to locomotivehead controller 106 (FIG. 1).

An additional peripheral lumen 290 is provided in multi-lumen tube 104for fluid communication with the interior of the intestine via slots 230in housing portion 208. Liquids or pressurized gas may be introduced ordrained through this lumen.

An inflatable balloon cylinder 300 is mounted onto rear portion 212 ofhousing portion 208. As seen clearly in FIG. 2, inflatable ballooncylinder 300 has a uniform cross section which includes three pairs 320of axial walls which extend along the longitudinal length thereof andengage corresponding axial slits 220 which extend to the rear of rearportion 212. Each pair 320 of axial walls is joined by a circumferentialwall portion 322. Axial walls pairs 320 are mutually separated along thecircumference of inflatable balloon cylinder 300 by 120 degrees.

Intermediate pairs 320 of axial walls there are defined three inflatableballoon portions 324, each of which separately communicates with aseparate inflation passageway 222. Balloon portions 324 are sealed withrespect to the rear portion 212 at forward and rearward ends thereof andat slits 220 by adhesive or in any other suitable manner to define threeseparate and independently controllably inflatable and deflatableballoon portions, distributed about the periphery of rear portion 212.It is appreciated that any suitable smaller or larger number of separateand independently controllably inflatable and deflatable balloonportions may be alternatively employed, although at least three suchseparate and independently controllably inflatable and deflatableballoon portions are preferred.

An inflatable balloon cylinder 350 is mounted onto forward balloonsupport 238. As seen clearly in FIG. 2, inflatable balloon cylinder 350has a uniform cross section which includes three pairs 370 of axialwalls which extend along the longitudinal length thereof and engagecorresponding axial slits 240 which extend to the rear of forwardballoon support 238. Each pair 370 of axial walls is joined by acircumferential wall portion 372. Axial walls pairs 370 are mutuallyseparated along the circumference of inflatable balloon cylinder 350 by120 degrees.

Intermediate pairs 370 of axial walls there are defined three inflatableballoon portions 374, each of which separately communicates with aseparate inflation passageway 242. Balloon portions 374 are sealed withrespect to the forward balloon support 238 at forward and rearward endsthereof and at slits 240 by adhesive or in any other suitable manner todefine three separate and independently controllably inflatable anddeflatable balloon portions, distributed about the periphery of forwardballoon support 238. It is appreciated that any suitable smaller orlarger number of separate and independently controllably inflatable anddeflatable balloon portions may be alternatively employed, although atleast three such separate and independently controllably inflatable anddeflatable balloon portions which are 60 degrees out of phase with theballoon portions on rear portion 212 are preferred.

It is appreciated that in accordance with a preferred embodiment of thepresent invention the balloon cylinders 300 and 350 are generallystretchable, and can be stretched to accommodate expansion to a radiusup to about 5-20 times greater than the radius of cylinders 300 and 350,when uninflated. Preferably inflation of balloon cylinders 300 and 350may be achieved using relatively low pressure, such as in the range of10-50 millibars.

It is appreciated that in accordance with a preferred embodiment of thepresent invention useful for in vivo inspection of a generally tubularbody portion having a variable cross-sectional diameter, the expansiondiameter range of balloon cylinders 300 and 350 is larger than themaximum cross-sectional diameter of the generally tubular body portion,thereby ensuring engagement of expanded balloon cylinders 300 and 350with the interior surface of the generally tubular body portion, andanchoring of the locomotive endoscope head 102 thereto. Preferably,balloon cylinders 300 and 350 are relatively soft, highly compliantballoons, operative to at least partially conform to the shape of theinterior surface of the generally tubular body portion when inengagement therewith.

It is appreciated that balloon cylinders 300 and 350 may be formed ofwell-known stretchable materials such as latex, flexible silicon, orhighly flexible nylon. Alternatively, balloon cylinders 300 and 350 maybe formed of polyurethane which is less stretchable and conforming thanlatex, flexible silicon, or highly flexible nylon. Preferably, ballooncylinders 300 and 350 have diameters which are sufficient to ensuretight anchoring at any part of the generally tubular body portion.

Reference is now made to FIGS. 5A, 5B, 5C, 5D, 5E, 5F and 5G, which aresimplified sectional illustrations, taken along lines IVB-IVB in FIG. 3,of the locomotive endoscope head of FIGS. 2-4C at various stages offorward motion through an intestine. As seen in FIGS. 5A-5G, locomotionof the locomotive endoscope head 102 of FIGS. 2-4C is achieved by acombination of sequential inflations and deflations of balloons, hererespectively designated by reference numerals 500 and 502 mounted ontothe housing portion 208 and the forward balloon support 238, combinedwith relative axial displacement of forward balloon support 238vis-à-vis housing portion 208. It is appreciated that each of balloons500 and 502 preferably includes multiple separate and independentlycontrollably inflatable and deflatable balloon portions as describedhereinabove.

Turning to FIG. 5A, it is seen that balloon 500 is inflated, thusengaging an inner wall of an intestine and fig the position of thehousing portion 208 relative thereto. In this orientation, the forwardballoon support 238 is shown in a rearward axial orientation, adjacentrear portion 212. Considering FIG. 5B, it is seen that forward balloonsupport 238 has moved axially forward relative to housing portion 208,while the housing portion 208 remains axially fixed relative to theintestine.

Turning to FIG. 5C, it is seen that with the forward balloon support 238in its FIG. 5B axial orientation, the balloon 502 is inflated, thusengaging the inner wall of the intestine and fixing the position of theforward balloon support 238 relative thereto.

Thereafter, as shown in FIG. 5D, balloon 500 is deflated.

Turning to FIG. 5E, it is seen that subsequent to deflation of balloon500, the forward balloon support 238 is moved axially rearward relativeto housing portion 208, while the forward balloon support 238 remainsaxially fixed relative to the intestine.

This results in axial forward movement of the housing portion 208 andthus of the locomotive endoscope head 102.

Turning to FIG. 5F, it is seen that with the forward balloon support 238in its FIG. 5E axial orientation, the balloon 500 is inflated, thusengaging the inner wall of the intestine and fixing the position of thehousing portion 208 relative thereto. Thereafter, as shown in FIG. 5Gballoon 502 is deflated.

It is thus appreciated that in this manner, forward displacement of thelocomotive endoscope head 102 is effected.

Reference is now made to FIGS. 6A, 6B, 6C, 6D, 6E, 6F and 6G, which aresimplified sectional illustrations, taken along lines IVB-IVB in FIG. 3,of the locomotive endoscope head of FIGS. 2-4C at various stages ofrearward motion through an intestine. As seen in FIGS. 6A-6G, rearwardlocomotion of the locomotive endoscope head 102 of FIGS. 2-4C isachieved by a combination of sequential inflations and deflations ofballoons, here too respectively designated by reference numerals 500 and502 mounted onto the housing portion 208 and the forward balloon support238, combined with relative axial displacement of forward balloonsupport 238 vis-à-vis housing portion 208. It is appreciated that eachof balloons 500 and 502 preferably includes multiple separate andindependently controllably inflatable and deflatable balloon portions asdescribed hereinabove.

Turning to FIG. 6A, it is seen that balloon 500 is inflated, thusengaging an inner wall of an intestine and fixing the position of thehousing portion 208 relative thereto. In this orientation, the forwardballoon support 238 is shown in a rearward axial orientation, adjacentrear portion 212. Considering FIG. 6B, it is seen that with the forwardballoon support 238 in its FIG. 6A axial orientation, the balloon 502 isinflated, thus engaging the inner wall of the intestine and fixing theposition of the forward balloon support 238 relative thereto.Thereafter, as shown in FIG. 6C, balloon 500 is deflated.

Turning to FIG. 6D, it is seen that forward balloon support 238 hasmoved axially forward relative to housing portion 208, while the forwardballoon support 238 remains axially fixed relative to the intestine.

Turning to FIG. 6E, it is seen that with the forward balloon support 238in its FIG. 6D axial orientation, the balloon 500 is inflated, thusengaging the inner wall of the intestine and fixing the position of thehousing portion 208 relative thereto. Thereafter, as shown in FIG. 6F,balloon 502 is deflated.

Turning now to FIG. 6G, it is seen that forward balloon support 238 hasmoved axially rearward relative to housing portion 208, while thehousing portion 208 remains axially fixed relative to the intestine.

It is thus appreciated that in this manner, rearward displacement of thelocomotive endoscope head 102 is effected. Alternatively, both balloons500 and 502 may be deflated and the locomotive endoscope head 102 may bepulled out of the intestine by pulling on the multi-lumen tube 104.

Reference is now made to FIGS. 7A-9C, which illustrate various differentorientations of the locomotive endoscope head 102 of FIGS. 2-4C whichmay be realized by suitable selectable inflation of individual balloonlobes of balloons 500 and 502. These illustrations are examples ofnon-parallel, tilted orientations achieved by any suitable non-identicalinflation of balloon lobes of balloon 500 as well as a correspondingnon-identical inflation of the balloon lobes 502 in an opposite sense,taking into account the phase difference in the rotational orientationsof the balloon lobes of balloons 500 and 502.

Turning to FIGS. 7A, 8A and 9A, there are seen illustrations of a first,downward facing, selectable tilting orientation of the locomotiveendoscope head of FIGS. 1-6G within a body passageway. This orientationis achieved by relatively low inflation of one balloon lobe of balloon500, here designated by reference numeral 510 and relatively highinflation of balloon lobes of balloon 500 designated by referencenumerals 512 and 514, at the same time as there is provided relativelylow inflation of one balloon lobe of balloon 502, here designated byreference numeral 520 and relatively high inflation of balloon lobes ofballoon 502 designated by reference numerals 522 and 524. It is notedthat in the orientation of FIGS. 7A-7C, balloon lobes 510 and 520 arerespectively at the top and the bottom of locomotive endoscope head 102,in the sense of FIGS. 7A-7C.

Turning to FIGS. 7B, 8B and 9B, there are seen illustrations of asecond, parallel orientation of the locomotive endoscope head of FIGS.1-6G within a body passageway. This orientation is achieved by generallyidentical inflation of balloon lobes 510, 512 and 514 of balloon 500 aswell as identical inflation of balloon lobes 520, 522 and 524 of balloon502.

Turning to FIGS. 7C, 8C and 9C, there are seen illustrations of a third,upward facing, selectable tilting orientation of the locomotiveendoscope head of FIGS. 1-6G within a body passageway. This orientationis achieved by relatively high inflation of balloon lobe 510 of balloon500 and relatively low inflation of balloon lobes 512 and 514 of balloon500, at the same time as there is provided relatively high inflation ofballoon lobe 520 of balloon 502 and relatively low inflation of balloonlobes 522 and 524 of balloon 502.

Reference is now made to FIGS. 10A and 10B, which are side viewillustrations of selectable parallel, off-center orientation of thelocomotive endoscope head of FIGS. 1-6G within a body passageway, toFIGS. 11A and 11B, which are rearward facing views corresponding toFIGS. 10A and 10B taken along planes XIA-XIA and XIB-XIB in FIGS. 10Aand 10B respectively and to FIGS. 12A and 12B, which are forward facingviews corresponding to FIGS. 10A and 10B taken along planes XIIA-XIIAand XIIB-XIIB in FIGS. 10A and 10B respectively. These illustrations areexamples of parallel orientations achieved by any suitable non-identicalinflation of balloon lobes 510, 512 and 514 of balloon 500 as well as acorresponding non-identical inflation of balloon lobes 520, 522 and 524of balloon 502, taking into account the phase difference in therotational orientations of the balloon lobes of balloons 500 and 502.

Turning to FIGS. 10A, 11A and 12A, there are seen illustrations of afirst off center parallel orientation of the locomotive endoscope headof FIGS. 1-6G within a body passageway. This orientation is achieved byrelatively low inflation of balloon lobe 510 and relatively highinflation of balloon lobes 512 and 514 of balloon 500 as well as acorresponding relatively high inflation of balloon lobe 520 andrelatively low inflation of balloon lobes 522 and 524 of balloon 502,which takes into account the phase difference in the rotationalorientations of the balloon lobes of balloons 500 and 502.

Turning to FIGS. 10B, 11B and 12B, there are seen illustrations of asecond, off center parallel orientation of the locomotive endoscope headof FIGS. 1-6G within a body passageway. This orientation is achieved byrelatively high inflation of balloon lobe 510 and relatively lowinflation of balloon lobes 512 and 514 of balloon 500 as well as acorresponding relatively low inflation of balloon lobe 520 andrelatively high inflation of balloon lobes 522 and 524 of balloon 502.

It may be appreciated from a consideration of FIGS. 7A-12B that inpractice any desired, geometrically permitted, orientation of thelocomotive endoscope head 102 may be realized if at least three balloonlobes are provided on both balloons 500 and 502. This includes, forexample up-down and side-to-side tilts and combinations thereof as wellas desired up-down and side-to-side off-center parallel orientations andcombinations thereof.

It is appreciated that various desired, geometrically permitted,orientations of the locomotive endoscope head 102 may be realized if atleast two balloon lobes are provided on each of balloons 500 and 502,and in particular if the at least two balloon lobes of balloons 500 and502 are azimuthally offset.

It is a particular feature of the present invention that due to the factthat the locomotive endoscope is moved other than by a push mechanism,multi-lumen tube 104 may be substantially more flexible than otherendoscope tubes.

Reference is now made to FIG. 13, which is a simplified pictorialillustration of an accessory 600 which is adapted to travel through theinstrument channel defined in the central passageway 202 of themulti-lumen tube 104 and in interior bore 274 of cylindrical portion 266of locomotive endoscope head 102. The accessory 600 may be selected fromamong any suitable accessories, such as biopsy forceps, polypectomysnares, foreign body retrieval devices, heat probes and needles, some ofwhich are well known in the art. In accordance with a preferredembodiment of the invention, a piston 602 is associated with theaccessory along its body 604 and upstream of its head 606. The piston602 is configured for slidable sealed motion along the instrumentchannel in response to pressure differences upstream and downstreamthereof, such as provided by suitable positive or negativepressurization of the instrument channel, which may be carried out forexample, by conventional insufflation and suction functionalities thatare provided in conventional endoscope systems.

Reference is now made to FIG. 14, which is a simplified partially blockdiagram, partially schematic illustration of part of the endoscopysystem of FIGS. 1-13, constructed and operative in accordance with apreferred embodiment of the present invention.

As seen in FIG. 14, a conventional endoscopy system 100, such as aconsole including a CV-160 video system center, a CLC-160 light source,an OEV-203 video monitor, and an OFP flushing pump, all commerciallyavailable from Olympus America Inc. of 2 Corporate Center Drive,Melville, N.Y. 11747, USA, is being employed. Conventional endoscopysystem 100 includes an inflation/suction generator 700 and a liquidsupply 702 which communicate via a flow control valve 704 with theinstrument channel defined by central passageway 202 of the multi-lumentube 104 and by interior bore 274 of cylindrical portion 266 oflocomotive endoscope head 102. The conventional endoscopy system 100also preferably includes an imaging system 710 and an LED controller 712which communicate via electrical data and power lines preferablyembodied in optical fiber and electrical conductor bundle 284 whichextend through lumen 286 in multi-lumen tube 104.

Operator control 108, preferably including a joystick 722, tilt/non-tiltfunctionality selection switch 724 and a button 725 for governing thedirection (forward/backward) and speed of motion, governs the operationof locomotive head controller 106. In a preferred embodiment of thepresent invention, as shown, the operator control 108 provides controlinputs to locomotive head control circuitry 726, which operates an airpressure generator 728, a vacuum generator 730 and a hydraulicpositive/negative pressure supply 732.

Air pressure generator 728 and vacuum generator 730 are coupled tolumens 226 and 246 for selectable inflation of balloon lobes 510, 512,514, 520, 522 and 524 via suitable manifolds 734 and 736 and viaindividual flow valves for each of the lumens, the flow valves beingdesignated by reference numerals 740, 742, 744, 746, 748 and 750.Hydraulic positive/negative pressure supply 732 is coupled via a flowvalve 752 to lumens 252 for driving piston rods 250. Additionally a flowvalve 754 governs supply of a treatment fluid to lumen 290 from atreatment fluid reservoir 756. A further fluid valve 758 governs removalof the treatment fluid via lumen 290 from the intestine to a discardfluid location (not shown) which is maintained under vacuum.

Flow valves 704, 740, 742, 744, 746, 748, 750, 752, 754 and 758 arecontrolled by operator control 108 via locomotive head control circuitry726 to suitably inflate and deflate balloon lobes 510, 512, 514, 520,522 and 524 for providing selected positioning and/or tilt of thelocomotive endoscope head 102 within the intestine; to suitably displaceforward balloon support 238 for locomotion of the locomotive endoscopehead 102 and for selectably supplying treatment fluid to the intestineas described hereinbelow with reference to FIG. 15.

Reference is now made to FIG. 15, which is a simplified pictorialillustration of the locomotive endoscope head of FIGS. 1-12B in anintestine fluid treatment mode of operation. As seen in FIG. 15, tubularbody portion sealing elements such as balloon lobes 510, 512 and 514 ofballoon 500 and balloon lobes 520, 522 and 524 of balloon 502 arepreferably all inflated, so as to seal the volume of the intestineintermediate balloon lobes 510, 512 and 514 and balloon lobes 520, 522and 524 from the remainder of the interior volume of the intestine.

Once sealing is achieved, a treatment fluid 760 is supplied fromtreatment fluid reservoir 756 via valve 754, lumen 290 and slots 230 tothe sealed portion of the intestine. Following treatment, the treatmentfluid 760 may be suctioned from the sealed portion of the intestine viaslots 230, lumen 290 and valve 758 to a fluid discard location (notshown). Optionally and preferably, treatment fluid 760 includes at leastone of a therapeutic fluid, a contrast enhancing fluid, an antisepticfluid, an acidic solution, a basic solution or any other suitable fluid.

Reference is now made to FIGS. 16A-16C, which are simplified pictorialillustrations of the locomotive endoscope head of FIGS. 1-12B in a guidewire mode of operation. As seen in FIG. 16A, balloon lobes 510, 512 and514 of balloon 500 and balloon lobes 520, 522 and 524 of balloon 502 arepreferably all inflated, so as to anchor the locomotive endoscope head102 to the intestine. Once anchoring is achieved at a desired location,multi-lumen tube 104 is tensioned, as seen in FIG. 16B.

It is appreciated that respective diameter of balloons 500 and 502 aresufficient to ensure tight anchoring at any part of the intestine.

As seen in FIG. 16C, an overtube 800 is slid over multi-lumen tube 104,using it as a guide wire. The overtube 800 preferably includes, at aforward portion 802 thereof, an endoscopy tool 804. Preferably,endoscopy tool 804 may be a therapeutic, diagnostic or surgical tool,and may be selectably positioned along the multi-lumen tube 104. In apreferred embodiment of the present invention, endoscopy tool 804 is anultrasonic transducer. In another preferred embodiment of the presentinvention, endoscopy tool 804 is an X-ray radiation source/generator.

Reference is now made to FIGS. 17-19B, which are respectively asimplified pictorial illustration of an endoscopy system constructed andoperative in accordance with another preferred embodiment of the presentinvention and respective simplified pictorial and sectional viewillustrations of an accessory constructed and operative in accordancewith a preferred embodiment of the present invention.

As seen in FIGS. 17-19B, a conventional endoscopy system 1000, such as aconsole including a CV-160 video system center, a CLC-160 light source,an OEV-203 video monitor, and an OFP flushing pump, all commerciallyavailable from Olympus America Inc. of 2 Corporate Center Drive,Melville, NY 11747, USA, is being employed. A conventional endoscope1002, which forms part of conventional endoscopy system 1000 may beemployed, such as a CF-Q160AL video colonoscope which is commerciallyavailable from Olympus America Inc. of 2 Corporate Center Drive,Melville, NY 11747, USA.

An endoscope tool 1010, constructed and operative in accordance with apreferred embodiment of the present invention extends through theinstrument channel 1011 of the conventional endoscope 1002. Endoscopetool 1010 is characterized in that it includes a multi-lumen tube 1012which includes at least a first lumen 1014 for inflation and deflationof a balloon 1016 via an inflation aperture 1017, and a second lumen1018. Preferably the second lumen 1018 may accommodate a tensioning orcompression wire 1020. Alternatively or additionally, the second lumen1018 may have other functionality. As a further alternative, themulti-lumen tube 1012 forming part of the endoscope tool 1010 mayinclude more than two lumens. Preferably, the cross-sectional area ofthe multi-lumen tube 1012 is sufficiently less than that of theinstrument channel 1011, so as to allow supply of fluid for insufflationand draining of fluid therethrough.

It is appreciated that in accordance with a preferred embodiment of thepresent invention the endoscope tool 1010 and the multi-lumen tube 1012are generally substantially more flexible than conventional endoscope1002 and an endoscope tube thereof.

It is appreciated that in accordance with a preferred embodiment of thepresent invention the balloon 1016 is generally stretchable, and can bestretched to a diameter about 5-20 times larger than its diameter whennot inflated. In a specific embodiment, useful for small intestineendoscopy, the balloon diameter when fully stretched is fourcentimeters. Preferably, inflation of the balloon 1016 to a diameterless than four centimeters may be achieved using relatively lowpressure, such as in the range of 10-50 millibars. In another specificembodiment, useful for large intestine endoscopy, the balloon diameterwhen fully stretched is seven centimeters. Preferably, inflation of theballoon 1016 to a diameter less than seven centimeters may be achievedusing relatively low pressure, such as in the range of 10-50 millibars.

It is appreciated that in accordance with a preferred embodiment of thepresent invention useful for in vivo inspection of a generally tubularbody portion having a variable cross-sectional diameter, the expansiondiameter range of balloon 1016 is larger than the maximumcross-sectional diameter of the generally tubular body portion, therebyensuring engagement of expanded balloon 1016 with the interior surfaceof the generally tubular body portion, and anchoring of the endoscopetool 1010 thereto. Preferably, balloon 1016 is a relatively soft, highlycompliant balloon, operative to at least partially conform to the shapeof the interior surface of the generally tubular body portion when inengagement therewith.

It is appreciated that balloon 1016 may be formed of well-knownstretchable materials such as latex, flexible silicon, or highlyflexible nylon. Alternatively, balloon 1016 may be formed ofpolyurethane, which is less stretchable and conforming than latex,flexible silicon or highly flexible nylon. Preferably, the diameter ofballoon 1016 is sufficient to ensure tight anchoring at any part of thegenerally tubular body portion.

As seen in FIGS. 17-19B, the endoscope tool 1010 preferably includes atool positioning control device 1024 and a balloon inflation/deflationcontrol interface 1026. It is appreciated that multi-lumen tube 1012 andthe entire endoscope tool 1010 may be inserted and removed via aconventional tool port 1030 on a conventional operator control 1032which forms part of conventional endoscope 1002.

Reference is now made to FIGS. 20A, 20B, 20C, 20D, 20E, 20F, 20G, 20Hand 20I, which are simplified illustrations of the endoscope tool 1010of FIGS. 17-19B in various operative orientations. In the illustratedembodiment, desired directional orientation of the forward end of theendoscope tool 1010 is obtained by suitable axial displacement of thetool through the instrument channel 1011 of the endoscope 1002 combinedwith suitable tensioning of wire 1020 and with suitable rotationalorientation of the endoscope tool 1010 relative to the intestine.

As seen in FIG. 20A, endoscope tool 1010 is principally located withinthe instrument channel 1011 of endoscope 1002, and has balloon 1016protruding therefrom, while in a deflated state.

FIG. 20B shows the endoscope tool 1010 extending further from theinstrument channel 1011, while FIG. 20C shows the endoscope tool 1010having been rotated by 180 degrees relative to its orientation in FIG.20B by suitable twisting of multi-lumen tube 1012, as indicated by arrow1022.

FIG. 20D shows bending of the forward end of the endoscope tool 1010resulting from tensioning of wire 1020, when the tool is in its FIG. 20Corientation having been pushed forward in a conventional manner.

FIG. 20E shows further progress of the endoscope tool 1010 through theintestine resulting from forward pushing of the tool coupled withrelease the tension on the wire 1020 by operation of tool positioningcontrol device 1024.

FIG. 20F shows inflation of the balloon 1016 by operation of the ballooninflation/deflation control interface 1026. In accordance with apreferred embodiment of the invention, this inflation anchors theforward end of the endoscope tool 1010 to the intestine at the locationof the balloon 1016.

FIG. 20G shows tensioning of the endoscope tool 1010 including themulti-lumen tube 1012 by pulling on the multi-lumen tube 1012.

FIG. 20H shows the endoscope 1002 having been pushed forward along themulti-lumen tube 1012, using the multi-lumen tube as a sort of guidewire. Endoscope 1002 may be pushed forward in a conventional manner.Thereafter, as shown in FIG. 19I, the balloon 1016 may be deflated.

Further forward progress of the endoscope through the intestine,preferably to a position where the forward end of the instrument channel1011 lies just behind the balloon 1016, similarly to the orientationshown in FIG. 20A, may be achieved by repeating some or all of the stepsdescribed hereinabove with reference to FIGS. 20A-20I, as required bythe geometries encountered.

Reference is now made to FIGS. 21-23B, which are respectively asimplified pictorial illustration of an endoscopy system constructed andoperative in accordance with another preferred embodiment of the presentinvention and respective simplified pictorial and sectional viewillustrations of an accessory constructed and operative in accordancewith a preferred embodiment of the present invention.

As seen in FIGS. 21-23B a conventional endoscopy system 1300, such as aconsole including a CV-160 video system center, a CLC-160 light source,an OEV-203 video monitor, and an OFP flushing pump, all commerciallyavailable from Olympus America Inc. of 2 Corporate Center Drive,Melville, N.Y. 11747, USA, is being employed. A conventional endoscope1302, which forms part of conventional endoscopy system 1300 may beemployed, such as a CF-Q160AL video colonoscope which is commerciallyavailable from Olympus America Inc. of 2 Corporate Center Drive,Melville, N.Y. 11747, USA. In accordance with a preferred embodiment ofthe invention, a peripheral balloon 1304 may be mounted onto endoscope1302 as shown. Preferably inflation and deflation of peripheral balloon1304 may be provided by a tube 1306 communicating with the interiorthereof.

An endoscope tool 1310, constructed and operative in accordance with apreferred embodiment of the present invention extends through theinstrument channel 1311 of the conventional endoscope 1302. Endoscopetool 1310 is characterized in that it includes a multi-lumen tube 1312which includes at least a first lumen 1314 for inflation and deflationof a balloon 1316 via an inflation aperture 1317, and a second lumen1318. Preferably the second lumen 1318 may accommodate a tensioning orcompression wire 1320. Alternatively or additionally, the second lumen1318 may have other functionality. As a further alternative, themulti-lumen tube 1312 forming part of the endoscope tool 1310 mayinclude more than two lumens. Preferably, the cross-sectional area ofthe multi-lumen tube 1312 is sufficiently less than that of theinstrument channel 1311, so as to allow supply of fluid for insufflationand draining of fluid therethrough.

It is appreciated that in accordance with a preferred embodiment of thepresent invention the endoscope tool 1310 and the multi-lumen tube 1312are generally substantially more flexible than endoscope 1302 and anendoscope tube thereof.

It is appreciated that in accordance with a preferred embodiment of thepresent invention the balloon 1316 is generally stretchable, and can bestretched to a diameter about 5-20 times larger than its diameter whennot inflated. In a specific embodiment, useful for small intestineendoscopy, the balloon diameter when fully stretched is fourcentimeters. Preferably, inflation of the balloon 1316 to a diameterless than four centimeters may be achieved using relatively lowpressure, such as in the range of 10-50 millibars. In another specificembodiment, useful for large intestine endoscopy, the balloon diameterwhen fully stretched is seven centimeters. Preferably, inflation of theballoon 1316 to a diameter less than seven centimeters may be achievedusing relatively low pressure, such as in the range of 10-50 millibars.

It is appreciated that in accordance with a preferred embodiment of thepresent invention useful for in vivo inspection of a generally tubularbody portion having a variable cross-sectional diameter, the expansiondiameter range of balloon 1316 is larger than the maximumcross-sectional diameter of the generally tubular body portion, therebyensuring engagement of expanded balloon 1316 with the interior surfaceof the generally tubular body portion, and anchoring of the endoscopetool 1310 thereto. Preferably, balloon 1316 is a relatively soft highlycompliant balloon, operative to at least partially conform to the shapeof the interior surface of the generally tubular body portion when inengagement therewith.

It is appreciated that balloon 1316 may be formed of well-knownstretchable materials such as latex, flexible silicon, or highlyflexible nylon. Alternatively, balloon 1316 may be formed ofpolyurethane, which is less stretchable and conforming than latex,flexible silicon or highly flexible nylon. Preferably, the diameter ofballoon 1316 is sufficient to ensure tight anchoring at any part of thegenerally tubular body portion.

As seen in FIGS. 21-23B, the endoscope tool 1310 preferably includes atool positioning control device 1324 and a balloon inflation/deflationcontrol interface 1326. Additionally, there is preferably provided aperipheral balloon inflation/deflation control interface 1328, whichcommunicates with tube 1306 and governs inflation and deflation ofperipheral balloon 1304. It is appreciated that multi-lumen tube 1312and the entire endoscope tool 1310 may be inserted and removed via aconventional tool port 1330 on a conventional operator control 1332which forms part of conventional endoscope 1302.

Reference is now made to FIGS. 24A, 24B, 24C, 24D, 24E, 24F, 24G, 24H,24L 24J, 24K and 24L, which are simplified illustrations of theendoscope tool 1310 of FIGS. 21-23B in various operative orientations.In the illustrated embodiment, desired directional orientation of theforward end of the endoscope tool 1310 is obtained by suitable axialdisplacement of the tool through the instrument channel 1311 of theendoscope 1302 combined with suitable tensioning of wire 1320 and withsuitable rotational orientation of the endoscope tool 1310 relative tothe intestine.

As seen in FIG. 24A, endoscope tool 1310 is principally located withinthe instrument channel 1311 of endoscope 1302, and has balloon 1316protruding therefrom, while in a deflated state. As seen, peripheralballoon 1304 is in a deflated state.

FIG. 24B shows endoscope tool 1310 being principally located within theinstrument channel 1311 of endoscope 1302, and has balloon 1316protruding therefrom, while in a deflated state. As seen, peripheralballoon 1304 is in an inflated state in engagement with an interior wallof the intestine, thereby anchoring the endoscope 1302 thereat.

FIG. 24C shows the endoscope tool 1310 extending further from theinstrument channel 1311, while FIG. 24D shows the endoscope tool 1310having been rotated by 180 degrees relative to its orientation in FIG.24C, by suitable twisting of multi-lumen tube 1312, as indicated byarrow 1340.

FIG. 24E shows bending of the forward end of the endoscope tool 1310resulting from tensioning of wire 1320, when the tool is in its FIG. 24Dorientation having been pushed forward in a conventional manner.

FIG. 24F shows further progress of the endoscope tool 1310 through theintestine resulting from forward pushing of the tool coupled withrelease the tension on the wire 1320 by operation of tool positioningcontrol device 1324.

FIG. 24G shows inflation of the balloon 1316 by operation of the ballooninflation/deflation control interface 1326. In accordance with apreferred embodiment of the invention, this inflation anchors theforward end of the endoscope tool 1310 to the intestine at the locationof the balloon 1316.

FIG. 24H shows tensioning of the endoscope tool 1310 including themulti-lumen tube 1312 by pulling on the multi-lumen tube 1312.

FIG. 24I shows deflation of peripheral balloon 1304.

FIG. 24J shows the endoscope 1302 having been pushed forward along themulti-lumen tube 1312, using the multi-lumen tube as a sort of guidewire. Endoscope 1302 may be pushed forward in a conventional manner.

FIG. 24K shows inflation of peripheral balloon 1304 into engagement withan interior wall of the intestine, thereby anchoring the endoscope 1302thereat.

Thereafter, as shown in FIG. 24L, the balloon 1316 may be deflated.

Further forward progress of the endoscope through the intestine,preferably to a position where the forward end of the instrument channel1311 lies just behind the balloon 1316, similarly to the orientationshown in FIG. 24B, may be achieved by repeating some or all of the stepsdescribed hereinabove with reference to FIGS. 24B-24L, as required bythe geometries encountered.

It will be appreciated by persons skilled in the art that the presentinvention is not limited to what has been particularly shown anddescribed hereinabove. Rather the scope of the present inventionincludes both combinations and subcombinations of various featuresdescribed hereinabove as well as modifications thereof which would occurto persons skilled in the art upon reading the foregoing specificationand which are not in the prior art.

1-198. (canceled)
 199. An endoscope assembly comprising: a locomotiveendoscope, including a locomotive endoscope head and an endoscope body,adapted for locomotion through a tubular body portion and for anchoringat a desired location in said tubular body portion; and an endoscopytool adapted for displacement along and over said endoscope body to adesired tool operation location.
 200. An endoscope assembly according toclaim 199 and also comprising at least one selectably radiallyextendible element associated with said locomotive endoscope head andadapted for anchoring said locomotive endoscope head at a desiredlocation in said tubular body portion
 201. An endoscope assemblyaccording to claim 200 and wherein said at least one selectably radiallyextendible element comprises a selectably inflatable anchoring balloon.202. An endoscope assembly according to claim 199 and also comprising anovertube which is slidable along said endoscope body and is associatedwith said endoscopy tool and wherein said endoscope body is adapted tofunction as a guide for said overtube.
 203. An endoscope assemblyaccording to claim 200 and also comprising an overtube which is slidablealong said endoscope body and is associated with said endoscopy tool andwherein said endoscope body is adapted to function as a guide for saidovertube.
 204. An endoscopy method comprising: providing a locomotiveendoscope including a locomotive endoscope head and an endoscope body;providing locomotion of said locomotive endoscope head through a tubularbody portion; anchoring said locomotive endoscope head at a desiredlocation in said tubular body portion; and displacing an endoscopy toolalong said endoscope body to a desired tool operation location.
 205. Anendoscopy method according to claim 204 and also comprising tensioningsaid endoscope body following said anchoring of said locomotiveendoscope head and prior to said displacing said endoscopy tool.
 206. Anendoscopy method according to claim 204 and also comprising, prior tosaid anchoring, the step of detecting said desired location in saidtubular body portion by use of at least one light source and at leastone imaging sensor associated with said locomotive endoscope head. 207.An endoscopy method according to claim 204 and also comprising, prior tosaid displacing said endoscopy tool, the step of detecting said desiredtool operation location in said tubular body portion by use of at leastone light source and at least one imaging sensor associated with saidlocomotive endoscope head.
 208. An endoscopy method according to claim204 and wherein said displacing said endoscopy tool comprises sliding anovertube associated with said endoscopy tool over said endoscope body.